Roub L W, Gumerman L W, Hanley E N, Clark M W, Goodman M, Herbert D L
Radiology. 1979 Aug;132(2):431-8. doi: 10.1148/132.2.431.
Thirty-five college athletes with lower leg pain underwent radiography and radionuclide studies to rule out a stress fracture. Their asymptomatic extremities and 13 pain-free athletes served as controls. Four main patterns were observed: (a) sharply marginated scintigraphic abnormalities and positive radiographs; (b) sharply marginated scintigraphic abnormalities and negative radiographs; (c) ill-defined scintigraphic abnormalities and negative radiographs; and (d) negative radionuclide images and negative radiographs. Since the patients with the first two patterns were otherwise identical medically, the authors feel that this scintigraphic appearance is characteristic of bone stress in the appropriate clinical setting, regardless of the radiographic findings. A schema is proposed to explain the occurrence of positive radionuclide images and negative radiographs in the same patient, using a broad conceptual approach to the problem of bone stress.
35名小腿疼痛的大学运动员接受了X线摄影和放射性核素检查，以排除应力性骨折。他们无症状的肢体以及13名无痛的运动员作为对照。观察到四种主要模式：(a) 放射性核素显像异常边界清晰且X线片阳性；(b) 放射性核素显像异常边界清晰且X线片阴性；(c) 放射性核素显像异常边界不清且X线片阴性；(d) 放射性核素显像阴性且X线片阴性。由于前两种模式的患者在医学上其他方面相同，作者认为在适当的临床背景下，这种放射性核素显像表现是骨应力的特征，而与X线检查结果无关。本文提出了一个模式，采用对骨应力问题的广泛概念性方法来解释同一患者放射性核素显像阳性而X线片阴性的情况。
